At on a Tuesday, inside a beige consulting room in Surrey, Martin asked a question that made his GP pause. She looked at his chart. The rain streaked the window while the doctor adjusted her black glasses. She sighed. Outside, the traffic moved with a sluggish consistency. Martin waited. “I honestly do not know anyone,” she said finally.
The GP was a generalist of high standing and long experience. She knew his history. She understood his concerns about his receding hairline and the impact it had on his morning routine. But the old networks of professional trust had grown thin and fragile. Doctors used to keep a mental rolodex of colleagues who were masters of specific crafts. They knew who had steady hands and who had a poor bedside manner. That informal system was the foundation of the medical district.
Earned through local reputation and accumulation of outcomes.
Determined by advertising budget and data transactions.
I once believed that the digital age had democratized expertise. I thought that by removing the “gatekeepers” of the old guard, we were finally allowing the best talent to rise to the top of the pile. In my years coordinating volunteers for the local hospice, I